TY - JOUR
T1 - Integrative physiological assessment of cerebral hemodynamics and metabolism in acute ischemic stroke
AU - Fan, Jui Lin
AU - Nogueira, Ricardo C.
AU - Brassard, Patrice
AU - Rickards, Caroline A.
AU - Page, Matthew
AU - Nasr, Nathalie
AU - Tzeng, Yu Chieh
N1 - Publisher Copyright:
© The Author(s) 2021.
PY - 2022/3
Y1 - 2022/3
N2 - Restoring perfusion to ischemic tissue is the primary goal of acute ischemic stroke care, yet only a small portion of patients receive reperfusion treatment. Since blood pressure (BP) is an important determinant of cerebral perfusion, effective BP management could facilitate reperfusion. But how BP should be managed in very early phase of ischemic stroke remains a contentious issue, due to the lack of clear evidence. Given the complex relationship between BP and cerebral blood flow (CBF)—termed cerebral autoregulation (CA)—bedside monitoring of cerebral perfusion and oxygenation could help guide BP management, thereby improve stroke patient outcome. The aim of INFOMATAS is to ‘identify novel therapeutic targets for treatment and management in acute ischemic stroke’. In this review, we identify novel physiological parameters which could be used to guide BP management in acute stroke, and explore methodologies for monitoring them at the bedside. We outline the challenges in translating these potential prognostic markers into clinical use.
AB - Restoring perfusion to ischemic tissue is the primary goal of acute ischemic stroke care, yet only a small portion of patients receive reperfusion treatment. Since blood pressure (BP) is an important determinant of cerebral perfusion, effective BP management could facilitate reperfusion. But how BP should be managed in very early phase of ischemic stroke remains a contentious issue, due to the lack of clear evidence. Given the complex relationship between BP and cerebral blood flow (CBF)—termed cerebral autoregulation (CA)—bedside monitoring of cerebral perfusion and oxygenation could help guide BP management, thereby improve stroke patient outcome. The aim of INFOMATAS is to ‘identify novel therapeutic targets for treatment and management in acute ischemic stroke’. In this review, we identify novel physiological parameters which could be used to guide BP management in acute stroke, and explore methodologies for monitoring them at the bedside. We outline the challenges in translating these potential prognostic markers into clinical use.
KW - Cerebral autoregulation
KW - near-infrared spectroscopy
KW - neuroimaging
KW - stroke
KW - transcranial Doppler ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85111356962&partnerID=8YFLogxK
U2 - 10.1177/0271678X211033732
DO - 10.1177/0271678X211033732
M3 - Review article
C2 - 34304623
AN - SCOPUS:85111356962
SN - 0271-678X
VL - 42
SP - 454
EP - 470
JO - Journal of Cerebral Blood Flow and Metabolism
JF - Journal of Cerebral Blood Flow and Metabolism
IS - 3
ER -